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Comment Upon coming across this rare finding, we wondered whether the meeting of the mite and the melanoma was merely coincidental or does the "beast" have a sixth sense that attracts it to melanoma cells? We were unable to find a report of similar findings in the English literature. Maybe, we are iust viewing a newer version of the "fatal attraction"? Baruch Kaplan, M.D. Henry Trau, M.D. Mirian Schewach-Millett, M.D. Tel Hashomer, Israel Reference 1. Head E, MacDonald M, Ewert A, Apisanthanarax P. Sarcoptes scabiei in histopathologic sections of skin in human scabies. Arch Dermatol 1990; 126:1475-1477.
The "Ugly and the Beast" To the Editor: The histopathologic examination of a pigmented lesion is crucial in diagnosing malignant melanoma. Head et al. recently described the features of histopathologic sections of the skin in scabetic infections.' We would like to share an anecdotal finding of an adult mite at the biopsy site of a melanoma.
Trace Elements in Serum of Pityriasis Alba Patients To the Editor: Thirty individuals (18 men and 12 women) with pityriasis alba were investigated in this study. The same number of healthy individuals was also selected to be a control group. Both groups were selected from out-patients clinics in United Arab Emirates hospitals and from the same age and social level. Serum samples from both groups were analyzed for determination of lead, copper, zinc, manganese, and carotenoids by use of atomic absorption spectrophotometry. The results were subjected to statistical analysis with the unpaired Student's t-test by computer.
Case Report A 73-year-old woman presented with a pigmented lesion on her forehead. At the time, she was residing in a geriatric institution and had a history of psychiatric illness. A biopsy of the lesion was performed and histopathologic examination revealed distinct features of malignant melanoma beneath an adult Sarcoptes mite (Fig. 1).
Results As shown in Table 1, there is no significant difference in the levels of zinc, lead, magnese, and carotenoids when comparing pityriasis alba patients with the normal control group. There was a significant difference in the level of copper between patients and controls (P < 0.0001). Discussion Pityriasis alba is a cutaneous eruption composed of hypopigmented scale lesions, which affects mainly exposed parts.' This disease is common in children and tends to subside spontaneously within a year.^ The etiology of pityriasis alba is far from clear. Efforts to isolate infectious agents common to this disease have not been successful.^ It has been suggested that nutritional deficiency might be an important factor,'' but this has been disputed.' Climatic factors and sunlight have also been suggested.*" Pityriasis alba has been regarded as a manifest Tahle 1. Trace Element Levels in Serum Patients (jig/dL) Control (\ig/dL) Zinc Lead Copper Manganese Carotinoids
Figure 1. Adult mite overlooking malignant melanoma, (hematoxylin and eosin, original magnification x 100)
Values are mean ± SEM.
105 ±2.42 4.35 ± 1.0 76.40 ±3.16 0.96 ±0.05 70.6 ±3.47
110 ±3.5 4.15 ±1.1 107 ±8.13 0.82 ±0.02 75.2 ±5.12